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Comparison of posterior ring fixation with combined anterior and posterior ring fixation for the treatment of lateral compression type 2 pelvic fractures.
International Orthopaedics ( IF 2.0 ) Pub Date : 2020-03-03 , DOI: 10.1007/s00264-020-04512-1
Bin-Fei Zhang 1 , Kun Shang 1 , Peng-Fei Wang 1 , Chao Ke 1 , Shuang Han 1 , Kun Yang 1 , Chen Fei 1 , Xin Xu 1 , Kun Zhang 1 , Yan Zhuang 1
Affiliation  

PURPOSE The aim of surgical treatment for lateral compression type 2 (LC-2) pelvic fractures is to enable early mobilization and provide pain relief. Anterior and posterior ring fixation is usually performed simultaneously, with the goal of providing good biomechanical stability. However, it is unclear whether anterior ring fixation is necessary. This study therefore aimed to determine the feasibility of isolated posterior ring fixation for LC-2 pelvic fractures. METHODS Records of patients with LC-2 pelvic fractures were extracted from a medical database. Patients who underwent posterior pelvic ring fixation alone (PR fixation group) or anterior and posterior ring fixation (APR fixation group) were included. Patients' operative characteristics, time to clinical healing, length of hospital stay, time to weight bearing, and complications were recorded at follow-up. Radiography was used to assess healing and fracture displacement. Functional outcomes were evaluated using the Majeed grading system. RESULTS The PR fixation group included 44 patients, and the APR fixation group included 49 patients. Operative time, intra-operative blood loss, units of blood transfused, intra-operative fluid administered, and post-operative drainage were lower in the PR fixation group than in the APR fixation group. Length of hospital stay was also shorter in the PR fixation group than in the APR fixation group. Although the frequency (8/44) of fracture displacement in the superior ramus prior to union was high in the PR fixation group, no significant differences in time to weight bearing, time to clinical healing, or Majeed scores were found between the groups at follow-up. CONCLUSIONS Isolated posterior ring fixation for LC-2 pelvic fractures is feasible; patients who underwent treatment with this technique had functional outcomes similar to that of those who underwent anterior and posterior ring fixation.

中文翻译:

后环内固定与前后环内固定治疗侧向加压2型骨盆骨折的比较

目的 侧向压缩 2 型 (LC-2) 骨盆骨折手术治疗的目的是实现早期活动并缓解疼痛。前环和后环固定通常同时进行,目的是提供良好的生物力学稳定性。然而,尚不清楚是否需要前环固定。因此,本研究旨在确定孤立性后环固定治疗 LC-2 骨盆骨折的可行性。方法 从医学数据库中提取 LC-2 骨盆骨折患者的记录。包括仅接受骨盆后环固定(PR 固定组)或前后环固定(APR 固定组)的患者。患者的手术特征、临床愈合时间、住院时间、负重时间、并在随访时记录并发症。放射照相术用于评估愈合和骨折移位。使用 Majeed 分级系统评估功能结果。结果 PR 固定组 44 例,APR 固定组 49 例。PR 固定组的手术时间、术中失血量、输血单位、术中输液和术后引流量均低于 APR 固定组。PR 固定组的住院时间也比 APR 固定组短。尽管 PR 固定组在愈合前上支的骨折移位频率 (8/44) 较高,但在后续组间发现负重时间、临床愈合时间或 Majeed 评分无显着差异-向上。结论 LC-2骨盆骨折单独后环固定可行;接受这种技术治疗的患者的功能结果与接受前后环固定的患者相似。
更新日期:2020-03-03
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